The puzzle pieces for weight maintenance are different from those for loss.
It is accepted as common knowledge that to keep the weight off, you need to continue doing the things you did to get it off. If everyone says this and believes it, then it must be right.
Or not.
That is the premise of a study to be published next month by Sciamanna et. al. in the American Journal of Preventive Medicine.
The authors asked, “what if there is a difference between the behaviors associated with successful weight loss and successful weight maintenance”?
As the authors point out, most maintenance-oriented programs focus on getting people to continue the behaviors that helped them lose weight. They do not focus specifically on behaviors known to help keep weight off. It turns out there IS a difference, after all.
And this is important, because getting people to focus on less helpful behaviors might be throwing them off track when they get to maintenance.
The authors surveyed 1165 US adults who responded to online and newspaper advertisements. 926 of these people said their BMI had been greater than 25 at some point (overweight).
To figure out what worked for weight loss they took these 926 people who had been overweight and split them into two groups. One group had lost at least 10% of their weight over the past year (98) and the other had not (828).
To figure out what worked for weight maintenance they took these same 926 people and split them into two groups. One group had lost at least 10% of their body weight more than a year ago and kept it off for at least a year (192). The other group had not kept the weight off or lost it in the first place (734).
They asked these people about what they do in their every day lives. There were questions about food management, physical activity, thinking about weight control, and about tracking methods.
Then they looked for patterns among what successful losers do and patterns among what successful maintainers do. And they found significant differences. For example, people who exercised consistently or ate plenty of lean protein were almost twice as likely to succeed in weight maintenance. People who engaged in a variety of exercise activities or planned their meals ahead were about two and a half times as likely to lose weight.
For losers, these were the behaviors most statistically significant (p less than or equal to 0.001):
- Eating plenty of fruits or vegetables
- Eating healthy snacks
- Limiting the amount of carbohydrates eaten
- Controlling portions
- Doing different kinds of exercise
For maintainers, these were the behaviors most statistically significant (p less than or equal to 0.001):
- Eating plenty of low-fat protein
- Following a consistent exercise routine
- Reminding yourself why you need to control your weight
There was only one behavior highly significant among both losers and maintainers:
- Thinking about how much progress you’ve made
- Participate in a weight loss program
- Look for information about weight loss, nutrition, or exercise
- Eat healthy snacks
- Limit the amount of sugar you eat or drink
- Plan what you’ll eat ahead of time
- Avoid skipping a meal, including breakfast
- Do different kinds of exercises
- Do exercises you enjoy
- Think about how much better you feel when you are thinner
- Eat plenty of low-fat sources of protein
- Follow a consistent exercise routine
- Reward yourself for sticking to your diet or exercise plan
- Remind yourself why you need to control your weight
- Write down what you eat and drink each day
What does this mean for us? It means that while transitioning from weight loss to weight maintenance we might need to adjust some of our behaviors. The two modes are distinctly different. It also means that once we’re in “maintenance mode,” if we do gain some weight back, we need to go back into “loss mode” until the weight is back in the happy range.
It means that we need to pay close attention to what works for us during this transition phase. I like to think of it as having training wheels on our maintenance programs. We need to take the time to figure out maintenance through trial and error.
This kind of study gives me tremendous hope. Hope that one day there will be dedicated, evidence-based programs designed specifically for weight maintenance. Hope that one day because of these programs more 20% of us will manage to keep the weight off.
Until that day we’re going to have to figure this out for ourselves from the primary literature and hobble along with the few weight maintenance programs there are – most a clumsy afterthought tacked onto the end of a weight-loss program that focuses on continuing weight-loss behaviors rather than emphasizing weight-maintenance ones.
Nice article!
Thanks for this. It’s so good to know there are other people struggling with maintenance out there! There’s sooooo little information on this topic and what there is is scary, suggesting that maintenance is nearly impossible.
That’s why, Angela, Sarah, Wayne and I are here — after three years of running Second Helping a hard truth has become apparent to me: The Powers That Be just don’t care about maintenance. Yet. It’ll take folks like us banding together to come up with answers until they come around.
So fret not. You’re among friends here.
What he said.
Plus, I don’t think they’ll care until someone figures out a way to make money from maintainers.
Sad, but true. Ca$h makes the world go around…
lol hate to call you out Ang, but you TOTALLY got that from me!
I do recall the days we went back and forth about that, you know! *tee hee*
Of course I got that from you. I just thought it needed to be said.
LOL!
This was useful. Some time ago I went from a BMI of about 29.0 and, after about a year, got to 20.5. I have maintained a band of 20.0 and 20.5 for about three years. The bad news is it hasn’t become easier. The good news is I can do it.
The technique I use involved counting everything – food as well as exercise. I try to cut out snacks and get about an hour of aerobic exercise a day. I’m a vegetarian (not a vegan), but found it is important to allow myself some regular treats. But even now I still have food cravings and realize my body isn’t self regulating on its own. I have to watch it all the time.
That sounds very familiar, Steve.
One of the maintainers I know over at the Spark People site (who has kept it off for 40+ years) says it’s still One Day at a Time for her. And she STILL has to hustle past the Reese’s in the store.
For me, heck, it’s sometimes One Hour at a time… LOL